New England HIMSS

HEALTHeLINK Overview

October 10, 2019

About HEALTHeLINK

• Collaborative partnership since 2001

(HEALTHeNET)

• Univera, HealthNow, Independent Health, Catholic

Health, ECMC, Kaleida, Roswell

• Supports 8 western counties of NYS

• Supports multiple DSRIP PPS efforts

• Part of the Statewide Health Information

Network for New York (SHIN-NY) – certified by

NYS DOH as a Qualified Entity

• One of the founding members of Strategic Heath

Information Exchange Collaborative (SHIEC) –

national collaborative for HIE’s – 120+ members

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Our Mission

To create and maintain a secure and reliable infrastructure for the timely and accurate electronic exchange of clinical information among health care providers and others involved in the delivery of health care services in Western New York and who are connected via the Statewide Health Information Network for New York (SHIN-NY). HEALTHeLINK will limit duplication, control health care costs and improve the delivery of services, clinical outcomes and patient safety.

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Better Health Lower CostsBetter Care

HEALTHeLINK Services

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Require Patient Consent No Patient Consent Needed

Patient Record Look-Up

• Clinical records from local data sources

• Practice data collected via CCDs

• Radiology images

• Medication history via Surescripts

• Additional data from statewide (SHIN-NY)

and national (VA) patient record look-ups

• Single sign-on access to I-STOP, eMOLST

Interoperability

• Results delivery (including IERD)

• EHR patient data (C-CDA) sent to

HEALTHeLINK at the close of an encounter

• Secure messaging

Alert Notifications

• Subscribe to patients

• Configure event profile

• Receive event notification

Data Repository/Analytics

• Community data aggregation

• Data standardization/content validation

• Specific data extracts (ACO, PPS)

• Population analytics and metric reporting

By the Numbers

• 100% of WNY hospitals participating

• More than 85% of WNY practices participating

• Approximately 5,100 participating providers

• 87% of WNY population consented

• Nearly 100% of laboratory results available

• More than 90% of radiology reports available

• Images from 20 radiology facilities available

• More than 400 data sources

• A query of HEALTHeLINK occurs every 5 seconds.

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Patient Summaries Viewed

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0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

1,600,000

1,800,000

2,000,000

2016 2017 2018 2019 (Projected)

1,000,500

1,200,300

1,590,000

1,900,000

Annual Queries vs. Patient Consent

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0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

8,000,000

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019(Proj)

Patient Records Accessed Annual

Consented Patients Accumulated

2019: 1,300,000

Consented Patients

Accumulated

2019 projection: nearly

7,000,000 Patient Records

Accessed

Impact of HEALTHeLINK usage

• Support during times of crisis

• Four major studies over past 6 years

• Each focused on different clinical settings

• Goal was to assess impact and benefit of HIE usage on:

• Clinical quality

• Administrative expense/revenue

• Patient experience of care

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Erie County Department of Health (2012)

• Leveraged HEALTHeLINK for epidemiology and disease

surveillance

• Significant improvements in tracking, specifically STD

surveillance, identification, treatment and reduction in spread of

disease

• Time savings = Improved productivity

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Erie County Department of Health (2013)

• ECDOH also utilizes to investigate cases of hepatitis B, tuberculosis

and rabies

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• HIE usage resulted in more STD contacts brought into care to prevent spread of disease

• Timely information on where to focus attention in providing resources and education

CT Scan Study (2013)

• Key findings:

• Approx. 90% of 2,763 potentially unnecessary duplicative CT scans ordered by physicians who either never or infrequently used HEALTHeLINK

• About 50% of patients with duplicative scan had already consented to HEALTHeLINK

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CT Scan Study (2013)

• More than 95% of potentially

unnecessary CT scans done in

hospital setting

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• Opportunity for enhanced patient safety by reducing

unnecessary radiation exposure

• Potential cost savings of $1.3 million to local health system

Emergency Dept. Pilot Study (2014)

• Clinical liaison was retrieving any potential clinically relevant

information 100% of the time for consented patients

• Study illustrated importance of efficient workflows to enable

providers to routinely access HEALTHeLINK for their patients

• Post-study, participating hospitals saw increase in

HEALTHeLINK usage from where they were pre-study

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Emergency Dept. Pilot Study (2014)

• Examine impact of HIE usage on reducing lab tests and

radiology exams in 3 emergency departments

• Validated assumption that there was clinical relevance and

value in using HEALTHeLINK in this setting

• 4x growth in use in ED’s across WNY since the study

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Up to 52% reduction in lab

testing

Up to 47% reduction in

radiology exams

Practice Workflow Pilot (2017)

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• Assess impact of incorporating HIE into practice workflow

• 6 low utilizing practices of HEALTHeLINK

• Explore opportunity for deeper adoption and HIE usage to

solve “pain points” for practice in obtaining patient information

and proactively supporting office visit

Practice Workflow Pilot (2017)

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Pre-visit planning

saved1.5 – 7 hourssearching for patient

information

Reduced patient

cycle time 18 –

40 minutes

• Development of practice workflow toolkit to assist with

increased integration of HEALTHeLINK into practice resulted

in sustained utilization once pilot completed

Practice Workflow Pilot (2017)

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• Brookings Institute fellow analysis on participating practice:

• 10.2% less readmissions

• 13.3% less emergency room visits

• Journal report is pending.

Crisis Support – Ransomware Attack

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Population Health Focus

• Change of strategy started with CPC+ designation for Buffalo

region

• Value Based Care support

• Leverage the unique position we are to support the community for

patient quality of care measure calculation

• HIE’s in a unique position to support these efforts with most

comprehensive and complete set of data!

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Patient Data Fragmentation

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26.80%

19.06%

14.56%13.33%

10.72%

7.36%4.34%

2.23%0.99%

0.61%0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

1 2 3 4 5 6 7 8 9 10+

Perc

enta

ge o

f Pat

ients

Number of EMRs

Western New York Patients in Multiple EMRs73.20% of patients have clinical data in more than one EMR

Measure Calculation Challenge We Address

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Claims Data

Claimed diagnoses, procedures, medications

Patient

Out of

Pocket

EHR

1EHR

2

EHR

3

EHR

4

EHR

5

EHR

6

EHR

7

EHR

8

EHR

10

EHR

9

Independent

Phar

mac

ies

Public

Heal

th D

epar

tment

Sure

Scri

pts

Federa

l Sourc

e (V

A/D

oD

/IH

S)

Claims:

Medicaid

Claims:

Commercial

1

MedicareCommerci

al

Claims:

Commercial

2

Claims:

Commercial

4

Claims:

Commercial

3Patient A

Patient B

Patient C

Patient D

Source – David Kendrick, MD MyHealth Access Network

What’s On the Horizon….

• Continue what we are doing

• Support for Social Determinants of Health

• Support for Advanced Directives

• Predictive Analytics

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National HIE Perspective• Strategic Health Information Exchange Collaborative (SHIEC)

• Patient Centered Data Home (PCDH) – national connections

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National Interoperability – SHIEC Survey Results

• Confirmation that Health Information Exchange organization’s are a critical part of the national HIT infrastructure

• Proof…:

• 92% of US population serviced by SHIEC HIE’s

• 1 billion alerts delivered by SHIEC HIE’s – local alerts and through PCDH

• The number of messages exchanged (CCD, ADT, ORU, etc.) and alerts delivered are SIGNIFICANT!

• Results being proposed for publication

• Nearly all responding HIE’s have partnered with one or more of the following: Public Health, Correctional Health, Social Services agencies, drug and alcohol treatment programs, first responders, school nurses, or blood banks – all members of the healthcare ecosystem.

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Questions?

Studies can be found at the HEALTHeLINK website:

http://wnyhealthelink.com/studies/

wnyhealthelink.com

716-206-0993

. facebook.com/healthelink

@healthelink

YouTube.com/healthelink

HEALTHeLINK

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